Barnett Brian S, Mulenga Macjellings, Kiser Michelle M, Charles Anthony G
Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Vanderbilt University School of Medicine, Nashville, TN 37232-0740, USA; Kamuzu Central Hospital, UNC Project, P-Bag 101, Lilongwe, Malawi.
Kamuzu Central Hospital, UNC Project, P-Bag 101, Lilongwe, Malawi.
Burns. 2017 May;43(3):602-607. doi: 10.1016/j.burns.2016.09.027. Epub 2016 Oct 12.
While psychological care, including supportive group therapy, is a mainstay of burn treatment in the developed world, few reports of support groups for burn survivors and their caregivers in the developing world exist. This study records the findings of a support group in Malawi and provides a qualitative analysis of thematic content discussed by burn survivors and caregivers.
We established a support group for burn survivors and caregivers from February-May 2012 in the burn unit at Kamuzu Central Hospital in Lilongwe, Malawi. Sessions were held weekly for twelve weeks and led by a Malawian counselor. The group leader compiled transcripts of each session and these transcripts were qualitatively analyzed for thematic information.
Thematic analysis demonstrated a variety of psychological issues discussed by both survivors and caregivers. Caregivers discussed themes of guilt and self-blame for their children's injuries, worries about emotional distance now created between caregiver and survivor, fears that hospital admission meant likely patient death and concerns about their child's future and burn associated stigma. Burn survivors discussed frustration with long hospitalization courses, hope created through interactions with hospital staff, the association between mental and physical health, rumination about their injuries and how this would affect their future, decreased self-value, increased focus on their own mortality and family interpersonal difficulties.
The establishment of a support group in our burn unit provided a venue for burn survivors and their families to discuss subjective experiences, as well as the dissemination of various coping techniques. Burn survivors and their caregivers in Malawi would benefit from the establishment of similar groups in the future to help address the psychological sequelae of burns.
在发达国家，心理护理，包括支持性团体治疗，是烧伤治疗的主要手段，但在发展中国家，关于烧伤幸存者及其护理人员支持小组的报道却很少。本研究记录了马拉维一个支持小组的研究结果，并对烧伤幸存者和护理人员讨论的主题内容进行了定性分析。
2012年2月至5月，我们在马拉维利隆圭的卡穆祖中央医院烧伤科为烧伤幸存者及其护理人员建立了一个支持小组。每周举行一次会议，为期十二周，由一名马拉维顾问主持。小组组长整理了每次会议的记录，并对这些记录进行了定性分析以获取主题信息。
主题分析表明，幸存者和护理人员都讨论了各种心理问题。护理人员讨论了因孩子受伤而产生的内疚和自责、对护理人员与幸存者之间现在产生的情感距离的担忧、担心住院意味着患者可能死亡以及对孩子未来和烧伤相关耻辱感的担忧。烧伤幸存者讨论了对长期住院过程的沮丧、与医院工作人员互动带来的希望、心理和身体健康之间的关联、对自己伤势及其对未来影响的反复思考、自我价值感下降、对自身死亡率关注度增加以及家庭人际关系困难。
在我们的烧伤科建立支持小组为烧伤幸存者及其家人提供了一个讨论主观经历的场所，同时也传播了各种应对技巧。马拉维的烧伤幸存者及其护理人员未来将受益于建立类似的小组，以帮助解决烧伤的心理后遗症。
